<!DOCTYPE html>
<html>
<title>Zepter Sale Engine</title>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
<meta name="viewport" content="width=device-width, initial-scale=1" />


<link rel="stylesheet" href="css/jquery.mobile-1.3.1.min.css" />
<link rel="stylesheet" href="css/idangerous.swiper.css">
<link rel="stylesheet" href="css/themes/my-custom-theme.css" />
<link rel="stylesheet" href="css/sidepanel.css">

<script type="text/javascript" src="js/jquery-1.9.1.min.js"></script>
<script type="text/javascript" src="js/jquery.mobile-1.3.1.min.js"></script>
<script src="js/jquery-1.10.1.min.js"></script>
<script src="js/idangerous.swiper-2.1.min.js"></script>

</head>
<body>
	<div data-role="page" id="registration-page">
		<div data-role="header">
			<div align="center">
				<img src="img/zepterlogo.png" alt="Smiley face" height="69" width="172">
			</div>
			<a id="back-button" href="p1.html" data-icon="back" data-transition="flip">back</a>
		</div>
		<div data-role="content">
			<form action="process.cfm" method="post">

				<fieldset data-role="fieldcontain">
					<label for="username">Username:</label> <input type="text" name="username" id="username">
				</fieldset>

				<fieldset data-role="fieldcontain">
					<label for="password">Password:</label> <input type="password" name="password" id="password">
				</fieldset>

				<fieldset data-role="fieldcontain">
					<label for="password2">Confirm Password:</label> <input type="password" name="password2" id="password2">
				</fieldset>

				<fieldset data-role="fieldcontain">
					<label for="email">Email:</label> <input type="email" name="email" id="email">
				</fieldset>
				
				<fieldset data-role="fieldcontain">
				<label for="mydate">Birth Date</label> <input name="mydate" id="mydate" type="date" data-role="datebox" data-options='{"mode": "flipbox"}'>
				</fieldset>
				

				<fieldset data-role="fieldcontain">
					<label for="hometown">Home Town:</label> <input type="text" name="hometown" id="hometown">
				</fieldset>
				
				<fieldset data-role="fieldcontain">
					<label for="hometown">Zepter Token:</label> <input type="number" name="hometown" id="hometown">
				</fieldset>

				<input type="submit" value="Register">

			</form>

		</div>
		<div data-role="footer">
			<h4>© Copyright 2009 Zepter International</h4>
		</div>
	</div>
</body>

</html>